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South Dakota rates for HCPCS 15150

Tissue cultured skin autograft, trunk, arms, legs; first 25 sq cm or less

Facilitymedian $871 · 10th–90th $589–$4,3650%10%20%10th90th$871Professionalmedian $912 · 10th–90th $575–$1,5490%10%10th90th$912$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $660.69 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $630.96 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,584.89 / $1,995.26
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $977.24 / $1,778.28
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $1,380.38 / $5,128.61
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,412.54 / $1,548.82
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $1,412.54
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,174.90 / $1,412.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $1,148.15 / $1,819.70
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,258.93 / $1,548.82